Kunuanunua Thomas Sengua, Nsibu Célestin Ndosimao, Gini-Ehungu Jean-Lambert, Bodi Joseph Mabiala, Ekulu Pépé Mfutu, Situakibanza Hypolite, Nseka Nazaire Mangani, Magoga Kumbundu, Aloni Michel Ntetani
Unité de Néphrologie Pédiatrique, Département de Pédiatrie, Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, BP 123 Kinshasa XI, République démocratique du Congo.
Nephrol Ther. 2013 Jun;9(3):160-5. doi: 10.1016/j.nephro.2013.01.001. Epub 2013 Feb 9.
Data on acute renal failure in complicated malaria in children in the Democratic Republic of Congo are sparse. The objective of this study was to document the profile of acute renal failure in severe malaria in admitted patients in pediatric hospitals from Kinshasa.
A prospective cohort study was conducted from January 2008 to December 2008 in children admitted in emergency units of five hospitals in Kinshasa for severe malaria.
In our series, 378 children with severe malaria were included. There were 226 boys and 152 girls (sex ratio 1.49). One hundred and ninety four (194) of these patients were under 5 years old. Acute renal failure was observed in 89 children (23.6%) and 87 of them had blackwater fever (BWF). This form of severe malaria was predominant in children older than 5 years. Quinine was the commonest antimalarial drug involved in the genesis of BWF. Dialysis was indicated in 23 children (24.0%) and was effective (acute peritoneal dialysis) in 21 patients. The death rate in children with ARF was 12.6% (n=87). Recovery of renal function was obtained by conservative treatment in the remained group.
This study confirmed the emergence of BWF in seemed protected autochthon children older than 5 years. BWF remained the leading cause of acute renal failure in complicated malaria among Congolese children in Kinshasa.
刚果民主共和国儿童复杂疟疾中急性肾衰竭的数据稀少。本研究的目的是记录金沙萨儿科医院收治的重症疟疾患儿急性肾衰竭的情况。
2008年1月至2008年12月，对金沙萨五家医院急诊科收治的重症疟疾患儿进行了一项前瞻性队列研究。
在我们的研究系列中，纳入了378例重症疟疾患儿。其中有226名男孩和152名女孩（性别比1.49）。这些患者中有194名年龄在5岁以下。89名儿童（23.6%）出现急性肾衰竭，其中87名患有黑水热（BWF）。这种重症疟疾形式在5岁以上儿童中占主导地位。奎宁是BWF发病中最常见的抗疟药物。23名儿童（24.0%）需要透析，21名患者（急性腹膜透析）透析有效。急性肾衰竭患儿的死亡率为12.6%（n = 87）。其余组通过保守治疗肾功能得以恢复。
本研究证实5岁以上看似受到保护的本地儿童中出现了BWF。BWF仍然是金沙萨刚果儿童复杂疟疾中急性肾衰竭的主要原因。
